赵东升 侯志峰

【摘 要】 目的：观察中西医结合治疗肝郁脾虚型帕金森病抑郁患者的临床疗效。方法：选取帕金森病合并抑郁且中医辨证为肝郁脾虚型的患者50例，随机分为对照组25例，观察组25例，两组病例均在基础治疗上予以米氮平口服，观察组加用逍遥散合柴胡疏肝散，每日1剂，早晚分服。两组均治疗4周。治疗前后分别使用汉密尔顿抑郁评定量表（HAMD）、帕金森病评定量表第一部分（UPDRS partⅠ），中医症候评分评估患者抑郁症状。结果：治疗后两组汉密尔顿抑郁量表、帕金森病评定量表、中医症候评分均较治疗前降低，且观察组较对照组下降更明显。结论：中西医结合治疗帕金森病合并抑郁患者疗效较好。

【关键词】 肝郁脾虚;帕金森病;抑郁

【中图分类号】R741 【文献标志码】 A 【文章编号】1007-8517（2021）08-0103-04

Abstract：Objective To observe the clinical efficacy of combine traditional Chinese and western medicine in the treatment of depression of Parkinson's disease with liver depression and spleen deficiency.Methods 50 patients with Parkinson's disease and depression with liver stagnation and spleen deficiency were randomly divided into control group （25 cases） and observation group （25 cases）.On the basis of basic treatment， the two groups were given mirtazapine orally， while the observation group was given Xiaoyao san and Chaihu Shugan san， one dose a day， in the morning and evening.Both groups were treated for 4 weeks.Before and after treatment， Hamilton Depression Rating Scale （HAMD）， Parkinson's disease rating scale part I （UPDRS part I） and TCM symptom score were used to evaluate the depressive symptoms.Results After 4 weeks of treatment， Hamilton Depression Scale， Parkinson's disease rating scale and TCM symptom score of the two groups were lower than before treatment， and the observation group was significantly lower than the control group.Conclusion The therapeutic effect of combine traditional Chinese and western medicine on Parkinson's disease complicated with depression is obvious.

Key words：Liver Depression and Spleen Deficiency; Parkinson's Disease; Depression

帕金森病（Parkinson's disease，PD）是我国常见的神经退行性疾病，多见于老年人。患者常伴有典型运动症状如静止性震颤、肌强直、姿势性障碍和运动迟缓，还会出现非运动症状如嗅觉减退、睡眠障碍、焦虑、抑郁、自主神经功能障碍等[1]，严重影响患者生活质量。其中，抑郁是临床常见并发症，发病率多在20%～70%[2]，并发抑郁会增加帕金森病的治疗难度，影响整体临床疗效评价，形成恶性循环。笔者通过观察在西医治疗基础上联合中药对于改善帕金森病抑郁患者的症状及生活质量的研究，分析中西医结合治疗的优势，现报告如下。

1 资料与方法

1.1 一般资料 选取安徽中医药大学第一附属医院脑病二科门诊及病房收治……